Biomedical subjects
Publications and source records attributed to J F Compère.
After briefly summing up the nosology of rhinophyma, the authors report their experience with the surgical correction of this nasal disease, on the basis of eight cases. They explain their reasons for giving up dermasection and preferring dermabrasion.
The authors, reviewing a series of 16 at least subtotal nasal reconstructions over the past 4 years, discuss the respective advantages of the two methods, which both give good results for this purpose. Nowadays, the balance favors expansion despite its duration and complexity for the very significant aesthetic benefits in terms of forehead scarring. The guidelines concerning this technique employed in 6 cases are described and reviewed in detail. Nevertheless, the Converse scalping flap remains a simple and quick solution especially after cancer resection in the elderly; some details seem important to diminish its sequelae.
Manufacture of personalized nasal masks by Biostar-press hot stamping of a bioplast plate has allowed for better prognosis of children with muscular dystrophy owing to the usually well supported, air-tight ventilation provided. Results have been encouraging and motivate us to utilise this type of mask in other patients as well, namely those with sleep apnea.
Delayed autotransfusion has been recommended for orthognathic surgery. The authors review and discuss the advantages of this technique. Emphasis is placed on the preventive aspect as it relates to transfusion-associated viral contamination, as well as on the positive implications on health expenditures in the long run. This technique requires excellent intercollaboration on the part of the blood transfusion centers and should definitely be recommended in certain cases of planned surgery. Furthermore, combined with hemodilution methods, it constitutes a very effective means of struggle against edema.
The authors are concerned with 16 recently operated cases, and express their renewed interest in vermilionectomy in the management of precancerous states affecting the vermilion, immediately followed by reconstruction with a mucous advancement flap. After describing the method, the authors stress the benefits afforded by the method from both oncologic and prophylactic viewpoints. Functional and esthetic results are excellent.
Repair of scalp tissue losses must reach two ends: Cover cranium and its contain while restoring hair. Only scalp flaps can attain these aims, but their disadvantage is most of the time to shift alopecia. For the major tissue losses, since skin expansion, treatment proceedings have changed: an immediate and temporary cover by a skin graft can be proposed, instead of multiple scalp flaps or free flaps. Few cases illustrate this alternative allowing discussion about their respective indications.
Classically, V-wedge excision of the lip allows direct closure of defects less than a third of its width. But undue tension may cause dehiscence of the suture lines responsible of narrowing of the mouth and excessive scarring especially on the external mucosa. To avoid these aesthetic complications modified incision should be made: W followed by a V-Y advancement closure, completed by a Z plasty on the vermilion.
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13 Converse scalping flaps have been done in the past 3 years. 11 cases were for nasal reconstruction, at least half nose which is its main indication including 4 after gun shot wounds and 7 for invasive skin cancers. The preference of this flap is discussed versus the other processes for reconstruction: median forehead flap whatever its design, Washio or orther fronto-auricular flaps, free flaps. Lining and framework repair are done in the same operation than cover when usefull. 2 other clinical cases illustrate other areas than nose where the Converse flap can be employed.
Reconstruction of the vermilion border in three patients with maxillofacial bullet wounds was by use of a tongue flap. The interest of a bifid flap is stressed, this providing a border capable of allowing almost normal opening of the mouth, and possessing the advantage of its removal from the ventral surface giving an appearance close to that of the uninjured commissural vermilion.
Two patients with ethmoidofrontal osteoma revealed by neurologic complications were treated by radical removal of osteoma by an endocranial approach with cranialization of frontal sinuses. Therapy varies with the localization of these osteomas.
The authors report their experience about 32 cases of island latissimus dorsi myocutaneous flaps used in Head and neck reconstruction: 29 where concerning cancer surgery, 3 traumatic after gun shots wounds. The advantages retained for explaining their use of this flap are discussed. The quality of the functional results, the versatility of its use and viability allow them to prefer it to any other one for reconstruction of large head and neck defects.
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Eight cases of isolated, mature and active arteriovenous malformations of scalp were explored and treated with embolization, alone or combined with surgery. A programme of exploration and the therapeutic approach as a function of angiographic findings are discussed, the latter being the basis for pathologic and hemodynamic features allowing classification of these malformations into two distinct groups.
The advantages of partial anterior chondrotomy for correction of protruding ears are discussed and detailed explanations provided with respect to the different surgical stages involved. The simple postoperative course and efficacy of this procedure are emphasized.
The diagnostic of ganglionnary invasion in oral cancer is established throughout the histological investigation practiced during the operation. This histological inquiry has to be rigorous and logical, in conformity with the anatomical particularities of the drainage tubes of the oral mucous. The accurate execution of this diagnostical strategy applied to the ganglionnary invasion improves the prognostic but requires a good logistic support.
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